Early Onset of Levodopa-Induced Dyskinesia in Parkinson's Diseased Patient: A Case Report

A 70-year-old woman with a prior cerebrovascular accident presented with classical Parkinsonian features and an atypical ulnar deviation of the wrist. A robust response to levodopa/carbidopa confirmed idiopathic Parkinson’s disease, but she developed severe levodopa-induced dyskinesia within two days of therapy initiation. Laboratory tests showed leucocytosis and markedly elevated ESR, while negative rheumatoid factor testing excluded rheumatological causes for the striatal hand deformity, supporting its attribution to Parkinson’s disease–associated dystonia. Discontinuation of levodopa led to complete resolution of the dyskinesia. This case highlights the diagnostic challenges of Parkinson’s disease in patients with comorbidities, the clinical relevance of striatal hand deformity, and the need for cautious titration of levodopa to minimize early-onset dyskinesia.